{"doi":"10.1111/1475-6773.14638","title":"Delaying Screening Until Covered? Changes in Lung Cancer Screening at the Age of Nearly‐Universal Medicare Insurance","abstract":"OBJECTIVE: To estimate changes in lung cancer screening at age 65, the age of nearly universal Medicare coverage. STUDY SETTING AND DESIGN: Screening reduces lung cancer mortality but is underutilized. We used a regression discontinuity design to measure the impact of nearly universal Medicare coverage at age 65 on first-time receipt of screening (primary outcome) and the proportion of screened individuals with detected lung cancer (secondary outcome). DATA SOURCES AND ANALYTIC SAMPLE: First-time screens at age 60-69 in the American College of Radiology's Lung Cancer Screening Registry data, 2015-2020. PRINCIPAL FINDINGS: Nearly-universal access to Medicare at 65 increased first-time lung cancer screening by 5450 per year (CI 4911-5990), a 41% increase compared to age 64. Eighty-nine percent of additional screens were among people who met screening eligibility criteria. Increases at age 65 were larger in rural areas than nonrural areas (52% vs. 39%) and were similar for men and women (41% and 42%). There was no statistically significant change in the proportion of screened individuals with lung cancer detected. CONCLUSION: First-time receipt of lung cancer screening increases at age 65, particularly among people in rural areas. Cancer detection rates did not worsen, suggesting screening remained well targeted as it increased.","journal":"Health Services Research","year":2025,"id":565527,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9399,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1469200,"name":"Adam Warren","orcid":null,"position":1,"is_corresponding":false},{"id":1018695,"name":"Lenka Goldman","orcid":"0000-0002-5856-4509","position":2,"is_corresponding":false},{"id":341427,"name":"Jamie L. Studts","orcid":"0000-0003-3922-3597","position":3,"is_corresponding":false},{"id":469066,"name":"Rebecca Myerson","orcid":"0000-0001-7567-936X","position":4,"is_corresponding":false},{"id":545926,"name":"Marcelo Coca Perraillon","orcid":"0000-0003-3355-3720","position":0,"is_corresponding":true}],"reference_count":42,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:56:28.709936Z","pmid":"40344226","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}